Three decades in the making, Nurses at Work is a fascinating history of occupational health nursing.
In 1961, after Nancy Bundle completed her general nurse training at the Royal North Shore and midwifery training at Hornsby, she took an unusual step for a newly qualified nurse. When a careers adviser asked if she’d like to work in a factory, she thought it “sounded different”, and she was soon employed as an occupational health nurse at British Automotive Industries at Campsie.
On the factory floor Nancy recalls being “thrown in the deep end”. She dealt with injuries ranging from burns and skin dermatitis from the oils the workers were exposed to, to treating a “tool maker using a grinding wheel which broke and exploded and (so did) parts of his eye”. At the time, the hazards of asbestos weren’t properly understood. “No one was concerned for the lady process worker who each day was covered in asbestos dust, or the cleaner who swept it up,” Nancy writes in a new book on the history of occupational health nursing in New South Wales, Nurses at Work.
As long as people have been making pottery and glass, dyeing fabric, preparing leather and painting buildings, workers have been using chemicals at work, Nancy notes in her book’s introduction. Men who worked in the felt hat factories using chemicals such as mercuric nitrate “experienced symptoms affecting the gums, mouth and skin… Drowsiness and depression could set in, together with hallucinations and delusions; this led to the expression ‘as mad as a hatter’.”
Industrial nursing may be a small nursing speciality, but Nurses at Work outlines a fascinating history. Nancy estimates that between 1911 and 2011 more than 1,400 registered nurses have worked as occupational nurses. What makes the role unique is that few “other health practitioners… could be consulted by workers in the early stages of physical or mental ill health and consequently be referred for appropriate medical attention”.
The union fostered solidarity among isolated nurses
Nancy left Automotive Industries when she was offered a job as an industrial nurse at the Email factory in Waterloo, an engineering company producing parts for gas and water meters. “While I was there I realised I really needed post graduate training in industrial nursing”. She took leave to study at the Royal College of Nursing, London. She returned to Australia and worked at Email newly qualified, but when the Occupational Health Nursing Adviser for NSW, Emmeline Roach, retired Nancy applied for the position and was appointed.
“The job involved giving advice to nurses working in industry, arranging education programs for them,” she explains. “Ms Roach had started a short course. We developed that course and made it a bit longer and more intensive.”
Nancy also wrote the first guidelines for the employment of OHS nurses, and she worked to establish formal post graduate training for nurses in NSW.
When a TAFE course commenced in 1981, Nancy applied for the teaching role and ran the course. Nancy had also become an active member of the occupational health nurse branch of the nurses’ union, serving in numerous roles, including president and committee member. The association was vital to developing professional ties and solidarity between nurses, Nancy says: “Because occupational nurses all worked alone, the only way they could achieve anything was in a group.”
Three periods of industrial nursing
The book describes three time periods reflecting the changing nature of industrial health nurses in NSW. The first period, 1911 to 1939, was a time when “nurses were really appointed to workplaces as part of the welfare movement,” Nancy says.
“In some companies, particularly retail stores such as Anthony Hordern and Farmers Ltd, managers came from the UK where industrial nurses were expected. Nurses were thrown in at the deep end and would have done whatever they thought they should do based on their nursing experience.”
Nancy’s book tells the story of a nurse employed by Farmers (later Myer) who was advised to read a 1923 article by Janet Sorley, who had been a ‘senior sister in charge’ at Farmers, and “just do what she did”.
Sorley’s article outlines treatments suggested for sick people at work and to prevent infectious diseases spreading. She also suggested the company should have a cottage somewhere in the country where people could recuperate.
The second period (1940–1959) incorporated the Second World War, and was very much influenced by implementation of emergency legislation that compelled dangerous industries to employ a nurse.
A move to prevention
The third period covers 1960 on, when the industrial nurse role significantly changed. There was now an emphasis on injury prevention.
“This was mainly due to the occupational health safety advisors who were changing the focus from treatment to preventions, identifying harmful factors in the workplace such as chemicals, loud noise and overuse work, strain injuries and things that caused back injuries.”
The peak number of nurses were employed in occupational nursing around 1970. Today the number of nurses in industrial roles has significantly declined, as Jim Kitay, Nancy’s co-author, explains in the book’s final chapter. Factors behind the decline include the rise of neoliberal ideologies (which aim to minimise short term costs and regulations), and the emergence of related occupations, such as occupational therapists, safety advisors and OHS consultants. The decline in manufacturing industries has also played a role.
More recently the focus on costs such as workers’ compensation premiums has “led to an emphasis on prevention (particularly on safety rather than illness prevention) and rehabilitation.
To purchase a copy of Nurses at Work: A history of industrial and occupational health nurses in New South Wales, by Nancy Bundle AM and Jim Kitay, contact gensec@ nswnma.asn.au.
